Top PDF Essays on health economics and risk preferences

Essays on health economics and risk preferences

Essays on health economics and risk preferences

I find that hospital size and total inpatient days decreased by almost a 20 percent, hospitals substitute towards more Medicare patients, and many converting hospitals clos[r]

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Essays in Empirical Health Economics

Essays in Empirical Health Economics

The second category of preventable risk factors consists of those factors that relate to characteristics of an individual’s living environment, such as air pollution, noise pollution or crime. In contrast to behav- ioral risk factors, environmental risk factors are not directly influenceable by individuals themselves. Some of these environmental characteristics and their potential spillover effects on individual health, most notably air and noise pollution, are already subject to an intense scientific as well as public debate (e.g. Janke, 2014; Bilger and Carrieri, 2013; Brink, 2011; Boes et al., 2013). The increased awareness of the effects of environmental characteristics is also reflected by several recent policy interventions that aim at reducing individuals’ exposure to these risk factors, such as bans on night flights or the introduction of low-emission zones in larger cities that became effective in Germany over the last years. While these prominent factors often lead to measurable impact on individuals’ physical health and, therefore, are in the focus of public interest, other potential threats that mainly affect individuals’ mental well-being have gained less attention. Understanding the role of environmental risk factors with respect to mental well-being is also emphasized by increasing prevalence rates of mental health problems, which have become a major concern in many developed societies. In Germany, for example, the number of diag- noses related to mental and behavioral disorders have increased by around 33 percent from 2000 to 2012 (Federal Statistical Office Germany, 2014b). In the same period of time, deaths caused by mental health problems have even increased by about 260 percent (Federal Statistical Office Germany, 2014a). Against this background, chapter 5 considers potential spillover effects of local crime rates on men- tal well-being of inhabitants. Crime and its potential spillover effects on mental well-being are one example
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Essays in health economics

Essays in health economics

Two observational studies report on ED health care use in Tennessee after the Medicaid contraction. Using a census of all Tennessee ED visits between 2004 and 2006 (inclusive), Heavrin et al. (2011) describe a 22 percent decrease in adult Medicaid visits and a 39.5 percent increase in uninsured adult visits in Tennessee after the contraction. They also note a 2 percent increase in the fraction of uninsured ED visits that result in inpatient hospitalization. Emerson et al. (2012) use the census of ED discharges for one Tennessee county (Davidson, which includes the city of Nashville) for 2003-2007 and report increases in both the number of ED visits for ambulatory-sensitive conditions and hospital uncompensated care costs after the disenrollment. Although their data also contained inpatient hospitalizations, the paper focuses only on ED visits; they do, however, note that the number of uninsured inpatient admissions among non-elderly adults increased by 42 percent, but there was only a very minor decline of 0.6 percent in Medicaid hospital admissions. Because these studies only use Tennessee data, it is unclear that we can draw causal lessons from them because some changes may reflect national trends. Additionally, unlike scheduled direct inpatient hospitalizations that are price sensitive, ED visits are less responsive to insurance status. Therefore, while these studies based on data from ED visits are informative, it is also important to examine utilization of hospital-based care, both scheduled and otherwise, using a quasi-experimental study design.
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Three Essays in Health Economics

Three Essays in Health Economics

Over the past several decades there has been an increased prevalence of both adult and childhood obesity in American society. This has received significant attention from researchers and governmental agencies, as there are both public health concerns and financial consequences associated with this condition. Obesity is associated with an increased risk for heart disease, stroke, type-2 diabetes, arthritis, and certain forms of cancer—all of which are serious (and costly) conditions. It has been estimated that medical expenditures associated with obesity account for 9% of all national medical expenditures in a given year. Nearly half of this bill is paid for by the government through Medicare and Medicaid expenditures, which translates to a higher tax bill for all tax-paying citizens. Moreover, it has been estimated that obese individuals who are Medicare (Medicaid) participants cost on average $1,486 ($864) more per year than their healthy weight counterparts (Finklestein et al. 2003).
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Four essays on risk preferences, entrepreneurship, earnings, occupations, and gender

Four essays on risk preferences, entrepreneurship, earnings, occupations, and gender

an inverse U-shaped relationship between risk-taking propensity and survival. That higher achievement is positively related to propensity to take an intermediate risk does not necessarily mean an inverse U-shaped relationship between risk attitudes and achievement. In their theoretical model, Caliendo et al. (2010) assume that less risk aversion is associated with higher expected payoff in the case of success, which yields the odd implication that the most risk averse picks projects with the lowest return conditional on success, regardless of variance. In addition, they did not model utility explicitly.
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Essays on trust, risk preferences and institutional changes in Vietnam

Essays on trust, risk preferences and institutional changes in Vietnam

The results fron1 Chapter 2 show that the war veterans has had long-tenn effects on economic development in Vietnam through their impact on overall provincial econ01nic governance and ot[r]

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Essays in Health Economics and Public Finance

Essays in Health Economics and Public Finance

To explore the impact of reimbursements on …rm advertising, we utilize data from Kantar Media. Kantar Ad$pender contains advertising data at the media-product-year- designated market area (DMA) level. Because DMAs are bigger than counties, we need to aggregate our reimbursement data. We create variables that represent the percentage of Medicare bene…ciaries in a DMA that live in an urban, urban ‡oor, and ‡oor county. We examine the impact of these variables on TV spot advertising spending per Medicare bene…ciary in a DMA. We de…ne this measure in two ways. In the …rst, we restrict our analysis to products with "Medicare" in their name. This includes Medicare Advantage plans, but also Part D and Medicare supplement plans as well. Furthermore, not all carriers report a speci…c Medicare line. The Kantar data does not allow us to distinguish between these products and data may be an overestimate or an underestimate of the amount of advertising for MA plans. However, we have no reason to believe that advertising for Medicare supplement or Part D plans would vary with ‡oor status. Average spending per Medicare enrollee is $5.90 per year. In the second de…nition and panel of Table 13, we take Kantar de…nition of "health insurance" as given, noting that not all Medicare products are denoted by name. While we would prefer to restrict to only Medicare Advantage products within health insurance, the products are not coded …nely enough in the data. However, Medicare products comprise the bulk of individual insurance plans sold (and, presumably, targeted advertising) within all DMAs.The dependent variable is skewed, with only about half of DMAs having advertising, but total spending in the 90th percentile of DMAs is $2.2 million per year.
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Essays In Health Economics

Essays In Health Economics

(iii) Control variables: In line with previous studies, I include the following control variables: age, gender, race and ethnicity, marital status, education and income levels. Group average is used for income since individual income is likely to be simultaneously determined with health status (Ruhm, 2005). 15 The BRFSS reports the income (in $) in the ranges: less than 10,000, 10,000-14,999, 15,000-19,999, 20,000-24,999, 25,000-34,999, 35,000-49,999, 50,000-74,999, and 75,000 and over. For the estimation purpose, respondent’s income is assumed to be at the midpoint of each range and 150 % of the top category and is then converted to 2012 year dollars using the all-items of CPI-U of the Bureau of Labor Statistic (BLS) (Ruhm, 2005). The weighted average incomes are calculated for 36 demographic groups stratified by sex (male versus female), age (25-29, 30-34, 35-39, 40-44, 45-49, and 50-55), and education (less than high school, high school or some college, and college) (Tekin, McClellan, and Minyard, 2015). I also control for local macroeconomic condition to alleviate the concern that it might be driving the relationship between local house prices and health (Ruhm, 2005). Monthly county-level unemployment rate from the BLS Local Area Unemployment Statistics database is used as a proxy for local macroeconomic condition . 16 In addition, I control for stock market condition using
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Essays In Health Economics

Essays In Health Economics

To study the population characteristics of the abusers, I aggregated the data annually, indicating if each individual had cases of abuse/dependence for alcohol, opioids, cocaine, amphetamines, or cannabis. Figure 2 shows the number of people who visited medical providers for any substance misuse during 2001-2012. The trends are similar to those reported by SAMHSA (2014a), which comes from the National Survey on Drug Use and Health. In 2001, the number of people with cannabis abuse problems was about 20% higher than those with opioid abuse/addiction. But opioid cases have grown much faster, and by 2012, there were twice as many cases of opioid abuse. Fortunately, the total number of individuals with cocaine abuse problems declined, and the number has stayed almost constant since 2005 for those with cannabis and amphetamine abuse problems. Table 5 shows that there is a high correlation between the abuse of different types of substances, with the highest being 0.35 for the correlation between opioid and other medications abuse. The correlation between abuse of opioids and other substances, including cocaine, cannabis, and amphetamines is 0.18, 0.14, and 0.10, respectively. For the rest of the data summary,
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Essays on bargaining theory and welfare when preferences are time inconsistent

Essays on bargaining theory and welfare when preferences are time inconsistent

1.8.1. Breakdown Risk and Non-linear Probability Weighting. One motive for im- patience in the sense of discounting future payos is uncertainty, such as mortality risk. Most recently, dynamically inconsistent discounting has been derived from violations of expected utilityspecically, the independence axiomin an environment with non-consumption risk; see e.g. Halevy [2008] and Saito [2011b]. This literature seeks to simultaneously explain ev- idence on risk preferences such as the Allais paradox and evidence on time preferences such as decreasing impatience (in the terminology of this paper, this is decreasing marginal pa- tience). In a manner analogous to how Binmore et al. [1986] translate the basic Rubinstein [1982] model into one where bargaining takes place under the shadow of a constant breakdown risk for expected-utility maximisers, I sketch here how the results of this paper can be used to study such a model where the bargaining parties violate expected utility. Building on Halevy [2008], suppose that, after each round, there is a constant probability of 1 − r ∈ (0, 1) that bargaining breaks down, leaving players without any surplus, and that a player i 's preferences over splits x ∈ X with delay t ∈ T have the following representation, whichfor the sake of simplicityinvolves breakdown risk as the sole source of discounting:
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Essays in the Economics of Health, Risk, and Behavior

Essays in the Economics of Health, Risk, and Behavior

risks in year t together and use the distribution of actual expenditures from year t+1 to generate beliefs about expenditure risk at the time the insurance plan was chosen in year t. Each person in the same risk group is assumed to have the same beliefs about his health risk. More specifically, I first group each insured individual into 60 different risk groups based on his age, sex, and severity score. I do not construct separate risk groups by year due to sample size limitations. For each of the 60 risk groups, I record the empirical proportion of individuals with zero expenditures the following year. For those with positive expenditures the following year, I fit a Weibull distribution to the observed expenditure, estimating the shape and scale parameters of this distribution. I exclude expenditures on preventive care since it was covered free of charge by all plans. I also only consider claims from in-network providers, which comprise nearly all spending. For each risk group, I then construct a “modified” Weibull distribution using the group’s estimated shape and scale parameters for positive expenditure and the empirical probability of zero expenditures. For each risk group, I take 100 draws from their corresponding modified Weibull distribution. Within each family, I sum the expenditures for each draw so that each family has 100 draws corresponding to the sum of expenditures for each of its members from that particular draw. This statistical object represents the family’s beliefs about its total expenditure risk. The family’s out-of-pocket risk is then constructed by applying the insurance plan’s de- ductible to each expenditure draw. In this setting, out-of-pocket payments simply equal spending if below the deductible, and the deductible if spending exceeds the deductible.
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Three Essays on the Economics of Health Reform.

Three Essays on the Economics of Health Reform.

Cervical cancer risk increases with age (Saslow et al. 2002), and false positives are very common among women under 20 (National Cancer Institute 2014). If increases in screening were concentrated among the youngest women, then it may be difficult to detect a change in mortality because deaths to younger women are a relatively rare event. However, if screening changes were driven by older women, then small changes in mortality will be easier to detect. Table 4.3 presents the results interacted with 10-year age categories. Among women aged 20-29 (the omitted group), living in a community with a funded family planning clinic increased the likelihood of having received a Pap smear in the previous year by almost six percentage points, or 8.5 percent in a model without state fixed-effects. While the effect among women aged 30-39 and 40-49 differed by only half a percentage point from the effect for women in their twenties, the youngest women (aged 14-19) were two percentage points less likely to have received a recent Pap smear than were women aged 20-29. Although the interaction is not statistically significant, a Wald test of the joint significance of the main effect and the interaction cannot reject that the effect is different from zero (p=0.55). The addition of state fixed-effects in column two increases the magnitude of the effect for women aged 20-29 to nine percentage points, or nearly 14 percent. However, the effect among the youngest women is four percentage points smaller, and remains statistically insignificant. The results suggest that the 8-13 percent screening increase was driven by women aged 20 and older.
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Empirical essays in the economics of health, housing, and the environment

Empirical essays in the economics of health, housing, and the environment

Despite accounting for national factors through year fixed effects, the interaction terms in these regressions could be picking up local trends in energy consumption that are correlated with our time invariant measures of preservation policies, e.g. due to sorting or other reasons. There are a variety of channels through which this could operate. To take one example, people who have preferences for heritage may be more likely to be wealthy individuals with relatively price inelastic demand for energy. Such individuals may also be more likely to own their homes rather than rent and hence may have greater incentives to make long-term investments in im- proving home energy efficiency, as found empirically by Davis (2011). 15 To address these issues we first include a set of variables in which linear time trends are inter- acted with a set of demographic and socio-economic variables drawn from the 2001 Census: share of residents with degree; share lone parents; share owner-occupiers; share ethnicity white; share age 45-59, share age 60+; share managers, professionals, or associate professionals; and share employed. Our estimated equation becomes:
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Essays on the economics of human capital and health

Essays on the economics of human capital and health

add new dimensions to existing knowledge, but at the same time aim to explain results from previous literature, mostly concerned with educational and labour market outcomes. The chapter analyses school and work aspirations at the end of compulsory schooling age, which can work as channels for later educational achievement and earnings. It looks at earnings and employment, but also at non-monetary measures of adult well-being, such as adult life and job satisfac- tion, self-efficacy and crime participation. Finally, it evaluates long-term effects of school type on adult self-assessed health and biomarkers for risk of cardiovas- cular disease up to age 55, based on the idea that more and better schooling improves an individual’s health production function (Grossman, 1972). A move to a more selective system today is expected to increase average peer ability and school quality for the additional pupils admitted to grammar, while these would decrease for lower-ability pupils who do not pass selection. To account for this key difference, the second contribution of Chapter 2 is to estimate two separate average effects of selective schooling, splitting the sample of pupils along the cog- nitive ability dimension. Thus, grammar pupils are compared to comprehensive pupils who, given their ability scores, would have gone to grammar, had they experienced the selective system. Similarly, secondary modern pupils are com- pared to comprehensive pupils who are closest to them in terms of ability. In practice, similarity is achieved through entropy balancing (Hainmueller, 2012), matching individuals on their pre-treatment characteristics. The strategy relies on the validity of the conditional independence assumption, the implications of which are discussed, also in light of previous criticisms to the reference literature (Manning and Pischke, 2006). Results highlight that grammar schools positively affect academic aspirations and employment prospects for their pupils, but they also lower adult life satisfaction, compared to their mixed-ability counterparts. Secondary modern pupils, of lower cognitive ability, display higher average adult wages and, in some specifications, higher self-efficacy than their comprehensive counterparts. However, regardless of the cognitive ability level, attendance to se- lective schooling is not significantly linked to other measures of health and human capital later in life.
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Essays in labor and public economics

Essays in labor and public economics

approaches use consumption responses to unemployment or job loss (combined with measures of the coefficient of relative risk aversion) to infer the value of unemployment insurance (Baily, 1978; Gruber, 1997; Chetty, 2006a). The main limitation of consumption- implementation approaches is their reliance on consumption data, for which availability is limited and often partial, and where there are issues of mis-measurement and difficul- ties with assignment to individuals within a household. From a theoretical standpoint, the approach also relies on the potentially strong assumptions of state-independent pref- erences and no anticipation effects. Partly in response to these limitations, recent work has developed revealed-preference, optimization-based approaches that exploit behav- ioral responses to estimate the welfare gains from social insurance. While most work has been done in the context of unemployment insurance (Shimer and Werning, 2008; Chetty, 2008; Landais, 2015; Hendren, 2017), similar approaches have been developed for social insurance against fatal and non-fatal health shocks (Fadlon and Nielsen, 2018; Dobkin et al., 2018). 11 I contribute to this literature by providing a simple revealed-preference method based on within-state participation responses to benefit losses that allows for state dependence and is applicable to a broad class of public policies involving income transfers. Moreover, because it requires labor supply rather than consumption data, the revealed-preference approach that I propose has the advantage of being widely applica- ble given the increasingly large availability of detailed data on individual labor supply from administrative and other sources.
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Essays in information economics

Essays in information economics

Secondly, the results explain why policy makers may prefer their information to be confidential in certain policy areas but publicly available in others, and how the choice of confidentiality can vary over time as the policy agenda evolves or new, more technocratic, policy makers get elected. These strategic preferences for confidentiality can be positively correlated with the quality of policy making even in the absence of a causal relationship between the two variables. Islam (2006) reports that higher levels of transparency are as- sociated with better governance and concludes that “there is a strong positive relationship between transparency and governance, with the likely effect running from the former to the latter”. Focusing on the effect of government transparency on informational lobbying suggests that there can be other factors, such as government expertise, moving both of these variables without the existence of a causal link between them. In fact, the model shows that shining too much light on the policy process can reduce the quality of policy making, and therefore have adverse consequences beyond those already identified in the literature (see e.g. Prat 2005).
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Essays on environmental and urban economics

Essays on environmental and urban economics

preferences differently, resulting in starkly different ex-post allocative efficiency. Therefore, I further investigate the role of state-level renewable policies in chang- ing allocative efficiency within-state and how it interacts with investors’ green pref- erences. I collect information on these policies from DSIREUSA (Database of State Incentive for Renewables and Efficiency), and loosely divide them into three cate- gories: quantity-based policies such as Renewable Portfolio Standard (RPS), per- unit-price-based (performance-based) policies such as feed-in-tariff and certain cor- porate tax breaks, and direct subsidies (non-performance-based) such as tax breaks on equipment and property. I try to aggregate several different policies into a single index of policy intensity under these three categories based on their impacts on the predicted profits of a typical wind farm project. In a simple difference-in-differences specification, I find RPS and price-based policies associated with significantly better locations of wind projects within-state. An important reason is that these policies are more attractive to pure profit-maximizing investors, who are adding capacities mainly in "brown" counties. Direct subsidies neither change within-state allocative efficiency nor have differential impacts on wind power capacity addition across coun- ties with different environmental attitudes. For better identification, I restrict my sample to gridcells around state borders and check the dynamic effects of renewable policy incentives before and after their actual implementation. The key results are robust to these alternative specifications.
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Essays in economics

Essays in economics

The data collected include information on all ocoipatioual pensions both defined benefit and defined contribution, it focuses on the allocation of pension funds’ assets and investments, [r]

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Essays on microeconomics

Essays on microeconomics

assumed to be risk-neutral. In this context, restrictions on the trading of ABS will have no effect on the objective well-being of agents, but will help to close the gap between the price of the underlying asset and its fundamental value. Nevertheless, the optimal policy for the case where there are different degrees of risk aversion is still an open question. In a full theoretical account of the 2007 crisis, both the boom and the bust of asset prices should be explained. This paper explains how the introduction of asset-backed securities allows belief disagreement to translate into an increase in asset prices. However, it does not explain how asset prices may eventually collapse. One possible option to explain this is to allow for agents to update their beliefs based on the return they get on the asset- backed securities. Once they realize that the actual return is below their expectations, the demand for the assets collapses. Another possible option is the introduction of liquidity constraints. In this framework, the agents who buy asset-backed securities with a return below the short-term bond will get into a debt spiral and eventually will hit a liquidity constraint. Since they will no longer be able to rollover their debts in order to buy asset-backed securities, the demand of the underlying assets will fall. A formalization of these narratives is left for future research.
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Essays in macro finance

Essays in macro finance

An increasing body of research has studied how uncertainty fluctuations influence busi- ness cycle dynamics. Within the framework of irreversible investment (see (Bernanke 1983), (Dixit and Pindyck 1994), (Abel and Eberly 1996), (Hassler 1996)), (Bloom 2009) studies the propagation of firm-level uncertainty shocks. Following an increase in un- certainty about future profitability, firms will slow down activities that cannot be easily reversed, i.e. they “wait and see”. After the heightened uncertainty is resolved, pent- up demand for capital goods leads to an investment boom. Another growing litera- ture stresses the interaction of risk and economic activity propagated through financial, rather than physical frictions. Using a model with financial frictions, (Gilchrist, Sim, and Zakrajsek 2014) argue that increases in firm risk lead to an increase in bond premia and the cost of capital which, in turn, triggers a decline in investment activity and mea- sured aggregate productivity. (Arellano, Bai, and Kehoe 2016) show that firms downsize investment projects to avoid default when faced with higher risk. Finally, (Christiano, Motto, and Rostagno 2014) analyze the macroeconomic implications of volatility shocks in the context of a financial accelerator model adapted from (Bernanke, Gertler, and Gilchrist 1999). Our analysis shows that when risk aversion is elevated, uncertainty shocks have larger and more prolonged impact. Although we take the increase in risk aversion to be exogenous, our analysis supports the literature that points to financial market frictions as an additional channel through which volatility fluctuations can af- fect macroeconomic outcomes: if risk aversion rises with tightening financial constraints, uncertainty may affect the economy via an increase in the risk premium.
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